Arterial and Venous Revascularization with Bifurcation of a Single Central Artery: A Reliable Strategy for Tamai Zone I Replantation
作者: Hsu, CC (Hsu, Chung-Chen); Lin, YT (Lin, Yu-Te); Moran, SL (Moran, Steven L.); Lin, CH (Lin, Cheng-Hung); Wei, FC (Wei, Fu-Chan); Lin, CH (Lin, Chih-Hung)
来源出版物: PLASTIC AND RECONSTRUCTIVE SURGERY 卷: 126 期: 6 页: 2043-2051 DOI: 10.1097/PRS.0b013e3181f44973 出版年: DEC 2010
被引频次: 2 (来自 Web of Science)
引用的参考文献: 19 [ 查看 Related Records ] 引证关系图
摘要: Background: Replantation of the distal phalanx and pulp can be performed to improve finger function and finger aesthetics; however, establishing adequate venous drainage is a challenge. Slattery et al. reported microsurgical reattachment of a partial distal phalanx with the use of a bifurcated terminal digital artery. The bifurcation was divided into two pedicles, one of which was used for venous drainage. In this article, the authors report their experience with a similar technique and propose a new algorithm for distal finger replantation.
Methods: From January of 2008 to February of 2009, five replantations were performed using a single central artery. The replanted levels were pulp, avulsed fingertip of the thumb, and distal phalanges. There was no volar vein, dorsal vein, or second artery available in the amputated part for standard venous drainage. Venous drainage in all cases was established by creating an anastomosis from a branch of the solitary terminal artery to a recipient vein.
Results: All digits were replanted successfully without evidence of arterial insufficiency or venous congestion. Partial necrosis was not identified postoperatively in any of the five fingers. There were no cases of wound infection.
Conclusions: A branch of the central solitary artery may be used successfully to reestablish venous outflow in cases of distal finger tip replantation. This technique allowed for the salvage of all fingers in this study without the use of leeches or other techniques used in cases of venous insufficiency. (Plast. Reconstr. Surg. 126: 2043, 2010.)
KeyWords Plus: DISTAL PHALANX REPLANTATION; FINGERTIP REPLANTATION; DRAINAGE; DIGITS; GRAFT
通讯作者地址: Lin, CH (通讯作者)
Chang Gung Mem Hosp, Dept Plast & Reconstruct Surg, 5 Fu Hsing St, Tao Yuan 333, Taiwan.
[ 1 ] Chang Gung Univ, Chang Gung Mem Hosp, Chang Gung Med Coll, Dept Plast & Reconstruct Surg, Guishan, Taiwan
[ 2 ] Mayo Clin, Div Plast Surg, Dept Orthoped Surg, Rochester, MN 55905 USA
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Web of Science 类别: Surgery
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